Provider Demographics
NPI:1235694761
Name:FIGUEROA ARAGON, AILICEC
Entity Type:Individual
Prefix:
First Name:AILICEC
Middle Name:
Last Name:FIGUEROA ARAGON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1411
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92693-1411
Mailing Address - Country:US
Mailing Address - Phone:949-412-7911
Mailing Address - Fax:
Practice Address - Street 1:18350 MOUNT LANGLEY ST STE 140
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6927
Practice Address - Country:US
Practice Address - Phone:949-540-4309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health